Provider Demographics
NPI:1801904362
Name:EILERMAN, LISA M (PA)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:EILERMAN
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:2950 BUSKIRK AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-6900
Mailing Address - Country:US
Mailing Address - Phone:888-380-0988
Mailing Address - Fax:289-236-3022
Practice Address - Street 1:444 W 8TH ST
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-1002
Practice Address - Country:US
Practice Address - Phone:619-474-8666
Practice Address - Fax:619-474-0325
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2024-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA17355363A00000X
CAPA17355363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ50473Medicare UPIN